Archive for cortisol

Hypothyroidism, or slowing of the thyroid, is a common problem as women age.

Too tired to Sleep

Many women develop this condition prior to the onset of the menopausal transition. The effects of aging on hormones can precipitate this condition and it is important for you to talk with your medical provider about testing for this if you are experiencing excessive fatigue.

The thyroid gland is located at the base of the neck and is responsible for the rate at which your body systems function. Symptoms of hypothyroidism include:

fatigue

dry skin

slowing of mental functions or difficulty thinking

constipation

hair loss

feeling cold

These are a few of the symptoms, there are many biological changes which occur that can be measured or evaluated by your provider. The reverse condition, called hyperthyroidism, is much less common and is not as associated with aging.

The thyroid gland produces the hormones, T3 and T4. This is regulated by thepituitary gland through production of TSH (thyroid stimulating hormone). The regulation of thyroid function in the pituitary gland(in the brain) is in turn regulated by the hypothalamus (also in the brain) by production of thyrotropin releasing hormone. It is through the action of elevated cortisol that this finely tuned system is altered.

Prolonged stress and the resulting production of CRH ( corticotropin releasing hormone) causes prolonged elevated amounts of cortisol. This in turn inhibits TSH production and secretion. The elevated levels of cortisol in the blood stream also inhibit conversion of the thyroid hormone T4 to T3. Our bodies need both forms of this thyroid hormone to function normally. T3 is produced in lower quantities but is 4 times more powerful than T4.

This could be the cause of what is termed the “sick euthyroid” syndrome. In this setting, people have all the symptoms of hypothyroidism but their thyroid lab work is normal. Some people can have difficulty converting T4 to T3 due to lack of an enzyme. So let’s put this together.

If you are a person who is genetically susceptible to these conditions, and you are entering peri menopause without a very healthy lifestyle. You are having trouble sleeping, your life is stressed and you are taking no time for yourself. You eat convenience food because you don’t have the time or energy to exercise and plan detailed meals. So your cortisol levels go up and you start gaining weight. Then it all spirals downward with more fatigue because your thyroid is not working well. What can you do to stop this?

We have talked about cortisol in prior posts, and many of you may be wondering why this particular

Too tired to Sleep

hormone is soimportant during menopause. We often think the cause of all our problems is from low estrogen. This is only part of the reason for your symptoms.

Cortisol is the stress hormone that we need when our bodies are under stress.The problem comes when our bodies have been under prolonged stress such as caused by hectic lives lacking adequate sleep and relaxation.

Cortisol increases heart rate,

slows digestion,

slows cell repair and regeneration,

breaks down healthy muscle and bone

weakens the immune system.

This increase in cortisol can wreck havoc on the balance of the different hormones that has been maintained. The falling estrogen levels also contribute to the stress response, as estrogen is involved in many functions within the body.

Cortisol is produced in the adrenal glands along with other hormones such as progesterone, some forms of estrogen, adrenaline, and testosterone. These hormones all come from the same parent hormones. What this means is that one hormone can be produced in excess at the expense of other hormones. When the body is under stress, the adrenals will cause the progesterone to be broken down to cortisol alone which leads to a reduction of DHEA (parent compound of estrogen and testosterone).

This cortisol then helps the liver to produce glucose because the body is anticipating the need for action and is providing the energy for this. In our modern day world, this kind of physical action rarely occurs, so what happens to all that excess glucose (sugar)? You guessed it, it is stored as fat. Usually visceral fat.

The adrenals also play a role in attempting to maintain estrogen levels as the ovaries are declining in function. The elevated cortisol levels will cause visceral fat to be made and stored in the abdomen. This visceral fat produces estrone, which is a form of estrogen. The adrenals produce estrone and belly fat produces estrone. This may very well be why all of a sudden, around the time of menopause, you have belly fat (or more belly fat)!

The adrenals do not act on their own, they have help from the brain. The brain, specifically the hypothalamus and pituitary, are the master controllers of our endocrine functions. Without these areas controlling and regulating, the separate organs may produce too much or too little of whatever hormone they are responsible for. During stress, the brain is attempting to reduce reproductive capacity, growth and thyroid function. This is done to help with survival. In this country and in this day and age, we are rarely in a position of having our very survival threatened. So the stress of our lives are unnecessarily causing all these problems.

So what do you do?

Reduce stress, reduce stress, reduce stress. This will reduce cortisol, which will hopefully reduce visceral fat production and reduce glucose production. This in turn will reduce heart disease, insulin resistance, and improve endocrine function of the non-stress hormones produced in the adrenals.

Reduce stress in a way that is enjoyable to you. Therefore you will be likely to make this part of your daily routine. Exercise, mediation, yoga. You must get adequate sleep, at least 7 hours a night. Your diet is important also, reduce sugar, alcohol, caffeine as these items can contribute to elevated cortisol levels.

Start with little changes, pick one new thing you will do and do it daily for a few weeks. When that is a common practice for you, pick another item you want to change. Change can be slow, this is often the more effective way to make changes that stick.

Anne Vaillancourt PAC

Write in the comments section and tell us your stories on changes you have made. Your story will most likely help and inspire someone else to make a change!

Fatigue is one of the most common problems that women voice as they are moving through the menopausal transition. We have discussed in previous posts the causes of fatigue in peri and post menopausal women. The reasons can be numerous and multifaceted.

Women can become anemic from irregular and heavy menses in peri-menopause, this can certainly cause fatigue.

Often times women on are medication to treat disorders and diseases, and these medications can cause fatigue.

Thyroid disorders can cause fatigue, as the thyroid hormonesare responsible for setting our metabolic rate (the rate at which our bodily functions work).

Lastly, depression and anxiety can cause fatigue mostly through the chemicals in our brain not being in enough supply or in the correct proportion.

Let’s talk about hormones and how they can affect fatigue. The steroid hormones are hormones produced for an action, production is stimulated by the brain, and they are meant for immediate use by the body. The hormones I will discuss are produced in both the ovaries and the adrenal glands. The hormones that are primarily responsible for the change in how you feel during menopause are:

estrogen

progesterone

testosterone

cortisol

DHEA

thyroid hormone T3 and T4

Cholesterol is the precursor for all of these hormones with the exception of thyroid hormones. Cholesterol is broken down into basically 2 parent compounds which then go through changes to become the above list with the exception of thyroid hormones.

One parent compound, pregnenolole eventually becomes

DHEA,

progesterone,

cortisol and

aldosterone.

The other parent compound becomes Adrostenedione which eventually becomes

testosterone,

estradiol,

estrone.

Why is this important for me to know?

Because knowledge is power. Once you understand what might be going on, you can decide to make changes to help relieve yourself of some of the symptoms you are experiencing.

Pre-menopausal, the production of these important hormones takes place in 2 places, your ovaries and your adrenal glands. Estrogen and progesterone in the ovaries and also in the adrenal glands, the rest are produced by the adrenals.

The adrenals are small organs which sit atop the kidneys. When the ovaries stop working, the production of progesterone starts a slow steady decline. The estrogen level falls rapidly but can also rise as the ovaries sputter along.

Many symptoms of bloating, fatigue and mood disturbance can be linked to not enough progesterone early in peri-menopause. While hot flashes, brain fog and fatigue can be linked to fluctuating and then low levels of estrogen. Prior to menopause, healthy estrogen levels help the action of cortisol which also helps to prevent cortisol excess. When estrogen falls, it leaves the cortisol unopposed and therefor in excess.

Why is excess cortisol bad?

Excess amounts of cortisol for prolonged periods of time can cause the following ill effects:

weaken the immune system

slow healing and normal cell repair

impair digestion

break down healthy muscle and bone

interfere with the normal function of other hormones

interfere with sleep

increase appetite

Cortisol is a very important hormone when it is needed for immediate action or a stress response. Today’s stressful lifestyles can cause prolonged increase levels of cortisol and as a result, the above list of problems can occur.

So what can a persondo to decrease the effects of hormonal changes and stress?

There is, of course, medication to treat the different symptoms. This you can discuss with your medical provider, it may mean you could be taking several different pills for all these different symptoms. What your medical provider may not have time to talk about are the lifestyle changes that can help all of this. (If you would like to talk to me about lifestyle changes, send me an email via out contact form. Click on the word contact on the black navigation bar at the top of this page.)

The following are all suggestions sited by the experts on how to change your lifestyle to help facilitate relief:

sleep-studies have shown people who get less than 4-5 hours of sleep are 72% more likely to be obese. This is due to hormones also

a diet low in sugars and refined carbohydrates can lower the entire cascade of hormones which help to create obesity and elevated cortisol levels.

a diet high in fresh vegetables and fruits, preferably produced locally so nutrients have not degraded, provides you with healthy anti-oxidants and other substances which the cells of our bodies utilize for healthy functions.

All this discussion of hormones and cortisol may seem mysterious and I will try to shed some light on the intricate interplay of these hormones in a future post. It is important to understand that you can change much of what is happening during menopause that is undesirable through your lifestyle.

It takes work and change and many people do not want to do this. The rewards of making changes and gaining some element of control over what is happening to your body can be very empowering. Every patient I have seen that successfully makes these changes have been immensely satisfied by the changes they have made. So ask yourself, what is stopping you from making the changes you know you should make?

I would like to hear from you in the comments section below. Things you can do are ask me

Anne Vaillancourt PAC

questions, tell me about your experiences, relate an epiphany you had or a way you have improved your energy. If you don’t want to do that, then share this with your friends on Facebook, Twitter or email by using one of the icons below.

Some people will be fat all their lives. It does not have to be that way. To be thin, they will have to have some help, but they will have to tell themselves they can do it. They will need some people around them saying the same thing. They will have to see themselves as OK despite being overweight. This slide show is an information tool. Anne and I want to be part of the support and accountability group for any woman who is in this situation over the age of 45.

If you would like to learn more or get some personalized information use our contact page to send us a message.

Please remember, we are not your medical providers. If you are going to make changes to effect your health, be sure to check with your doctor first. It is a very good idea to have a relationship with a health care provider you trust who can advise you. We provide information only. Discuss this information with your health care provider.

If insulin is my problem, why did it wait until menopause to cause

me trouble?

Excess insulin is a problem throughout life but we are protected by a larger muscle mass when we are younger and by increased activity. We also had better things to do than late night snacks. That muscle mass protected you until your thirties. Then you began to lose about 1% of your red muscle mass per year. A very slow decline but 15-20% of the muscle you started with disappears by age 50-55. Now your arm may be the same size or a little bigger but the percentage of muscle to fat has decreased unless you have been very disciplined about your diet and exercise routine. A few people have strong established habits that keep them fit and maintain their muscle mass and thus a smaller more compact size and stronger bones.

What can I do about insulin now?

Insulin is your friend when it isn’t over stimulated. It responds to glucose in the blood. Any food you eat that raises glucose rapidly will cause an associated spike in insulin. Regular consumption of food that delivers a rapid blood glucose elevation is going to cause you more rapid weight gain. To keep this from happening, you need to eat foods that do not release their starches and/or sugars quickly or if they do, must not contain a large amount per serving.

Glycemic index is the speed with which the sugars contained in a food are released into the bloodstream. This release will stimulate insulin and the more sugars released the greater the insulin response. Eating foods with a lower glycemic index will keep insulin levels low.

Glycemic load is the amount of sugar in a serving. Most, but not all high glycemic index foods also have a high glycemic load. A low glycemic index is between 1-55, medium is 56-69 and high is 70-100. Glycemic load is low from 1-10, medium 11-19 and high from 20 on up.

Foods with a low index and low load include Apples – load 4, index 38, Peanuts load 1, index 14, Strawberries or any berry is about the same – load 1, index40.

Corn flakes have a load of 21 and an index of 81!!!! Get the idea! Most fresh fruits and many vegetables (not french fries) are low in load and index or have a low load even if the index is medium or above.

Don’t forget about stress!

There was the issue of the stress response raised in my first article. Cortisol raises blood glucose levels and stimulates an insulin response. This creates all kinds of havoc. You can have low blood sugar in your sleep, you might wake up sweating and shaking and think it was a bad hot flash or flush when really glucose spiked from stress and maybe some high glycemic index bedtime snacks (ice cream or milk and cookies). Then insulin followed and lowered your glucose levels fast – too fast – the glucose bottoms out. Guess what? Now you have a real emergency! More adrenaline and more cortisol and puff – you are awake, shaky and slightly sweaty. You feel a need to pee and while you are up, maybe a drink of water that leads to a few bites of this or that left over etc… Too many total calories will make you gain weight too.

Just 100 calories per day too many will eventually lead to one extra pound of fat in 35 or so days. Just 10 extra calories a day is a pound plus per year. 15-20 pounds by age 50-55 and a lot less muscle. Don’t think you can just walk off those pounds, you have to cut your calories to what you need for your ideal weight and activity level. Then, activity will make a difference – with an appropriate diet. It is fairly simple, but not easy. There are many interested parties that want you to eat more of what they are selling. Tell them they are evil and they will tell you that you are irresponsible. You’ve got to guard what enters that brain of yours through your eyes and ears.

Need some help? Confused? Think I am exaggerating all this? Leave me a comment and tell me what you think. If enough of you want to, I will get my partner, Bruce who is a physician assistant and life coach and the webmaster here, to set us up a live teleseminar. Then all of you, he and I can get together on line, privately and discuss all of this. Let me know how I can help you.